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How to Level Up the Revenue Cycle Management Game Plan

In the ever-evolving healthcare landscape, efficient revenue cycle management (RCM) is crucial for maintaining a financially healthy practice. Adopting a proactive and strategic approach to RCM can make all the difference in addressing heavy administrative workflows, billing errors, increasing denials and staffing shortages. Here are four top strategies from Greenway Health's Senior Director of Revenue Consulting, Marvin Luz, to help you level up the RCM game plan and ensure practices collect every dollar earned. 

1. Proactive Patient Collection Strategies 

Growing patient accounts receivable (A/R) is a common challenge but can be mitigated with more proactive collection strategies. Start by ensuring the patient financial policy is updated and signed by patients annually. Implement a system where patients provide a credit card on file to collect payments upfront, reducing the need to chase potential revenue later. Achieving this requires buy-in from both staff and patients, along with clear communication of the importance of these processes. 

Implementing proactive patient collection strategies starts with a thorough review of current financial policies. Ensure they are comprehensive and cover aspects such as payment timelines, accepted payment methods and consequences of non-payment. Educate patients about these policies during their visits, ensuring they understand the importance of timely payments.

Additionally, consider leveraging technology such as patient portals where patients can view their bills and make payments easily. This not only improves convenience but also reduces the administrative burden on staff. 

2. Improve Patient Registration and Eligibility Checks 

Increasing denials can often be traced back to errors in patient registration. Ensure staff is thoroughly trained to capture accurate demographic information and verify insurance details ahead of time. Automating the verification process before the patient visit can prevent common front-end rejections and delays in collections. Staff should be trained to understand verification responses, making it clear which services are covered and what patients need to pay. 

To further minimize errors, conduct regular training sessions and refresher courses for registration staff. Equip them with checklists and guides to capture all necessary information accurately. Additionally, use predictive analytics tools to identify common registration errors and implement targeted interventions to address them. This proactive approach not only reduces denials but also enhances patient satisfaction by ensuring a smoother registration process. 

3. Develop Patient-Friendly Payment Plans 

Creating diverse and well-defined payment plans can significantly increase a patient's propensity to pay their bills. Simplifying the payment process encourages prompt payments, ensuring a steady stream of collections. Avoid becoming a creditor for patients by offering payment plans that accommodate their financial situations while ensuring the practice’s financial health. 

When designing payment plans, consider the different financial circumstances of patients. Offer options such as installment plans, discounts for early payments, and automatic payment setups. Communicate these options clearly to patients, highlighting the benefits of each plan. Regularly review and adjust payment plans based on patient feedback and changing financial landscapes to ensure they remain effective and relevant. 

4. Maximize EHR and PM System Capabilities 

Manual processes can consume valuable time and resources. Leverage the full functionalities of your electronic health record (EHR) and practice management (PM) systems; these systems are designed to streamline workflows and improve operational efficiency. If you're unsure of the features available, reach out to the technology vendor for training. Consider partnering with the vendor for revenue cycle management services to optimize system use and enhance revenue cycle outcomes. 

To fully leverage EHR and PM systems, start by conducting a thorough assessment of their capabilities. Identify features that are currently underutilized and develop a plan to incorporate them into daily operations. Request customized training sessions from the vendor, focusing on the specific needs of the practice. Furthermore, stay updated on new software updates and enhancements, ensuring systems always operate at peak efficiency. 

Activation and Team Engagement 

With these strategies in mind, practices can create an RCM game plan or level up their strategies. Educate staff on process changes, demonstrating the positive impact on both the bottom line and patient satisfaction. Document processes in a playbook to keep everyone aligned and ensure consistent implementation. 

Solicit input and feedback from the team during the creation of an RCM game plan. This collaborative approach ensures buy-in and increases the likelihood of successful implementation. Regularly review and update the game plan to adapt to new challenges and opportunities.  

Implementing these proactive strategies can significantly enhance a practice’s financial stability and operational efficiency. By adopting a strategic approach to RCM, practices can improve revenue collection, reduce administrative burdens and ultimately provide better care for patients.

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